超声压力-应变环评价诺欣妥治疗慢性心衰患者左室心肌做功改变  

Evaluation of left ventricular myocardial function in chronic heart failure patients treated with sacubitril/valsartan by pressure-strain loop

作　　者：苏桥慧 张丽萍[1] 梁重霄 徐晶[1] 徐卉[1] SU Qiao-hui;ZHANG Li-ping;LIANG Chong-xiao;XU Jing;XU Hui(The First Hospital of Jilin University,Changchun 130021,China)

机构地区：[1]吉林大学第一医院,吉林长春130021

出　　处：《中国临床医学影像杂志》2023年第2期109-112,117,共5页Journal of China Clinic Medical Imaging

基　　金：吉林省医疗卫生人才专项(项目编号:JLSCZD2019-046)。

摘　　要：目的:应用超声压力-应变环评价经诺欣妥治疗的慢性心衰患者的左室心肌做功改变。方法:选取2019年12月-2020年12月吉林大学第一医院临床确诊为射血分数降低型慢性心力衰竭患者40例,用药前、用药后1月及用药后3月进行经胸超声心动图检查、血浆NT-proBNP浓度及6 min步行试验,获得以下压力应变环技术参数:左室整体纵向应变(GLS)、整体有用功(GCW)、整体做功效率(GWE)、左室心肌整体做功指数(GWI)、整体无用功(GWW)。其他参数:血浆NT-proBNP浓度及6 min步行试验结果,比较用药前后各个参数之间的差异及LVEF与左室心肌做功参数的相关性。结果:用药前、用药后1月、用药后3月GLS绝对值逐渐增加,心肌做功参数中GWI、GCW、GWE均较用药前增加,GWW较用药前减小,GWI、GCW、GWE与LVEF呈正相关(用药后1月r=0.945、0.922、0.925;用药后3月r=0.621、0.706、0.799,均P<0.001),GWW与LVEF呈负相关(用药后1月r=-0.960;用药后3月r=-0.789,均P<0.001),且各个指标用药前、后对比差异有统计学意义(P<0.001)。结论:慢性心力衰竭患者服用诺欣妥后心肌做功情况有所改善,左室心肌做功参数可以用来评估慢性心衰患者的病情及预后情况。Objective: To evaluate the left ventricular myocardial function of patients with chronic heart failure treated with sacubitril/valsartan by pressure-strain loop. Methods: Forty patients with chronic heart failure and reduced ejection fraction in the First Hospital of Jilin University from December 2019 to December 2020 were included. Echocardiography, plasma NT-proBNP concentration, and the 6-minute walk test were performed in these patients before medication, 1 month and 3months after medication. The parameters were as follows: global longitudinal strain(GLS), global constructive work(GCW), global work efficiency(GWE), global work index(GWI), global wasted work(GWW), plasma NT-proBNP concentration and 6-minute walk test results. The differences between the parameters before and after medication were compared. Results: The absolute value of GLS increased gradually, the GWI, GCW and GWE of myocardial work parameters increased and the GWW decreased compared with before medication, 1 month and 3 months after medication. GWI, GCW and GWE were positively correlated with LVEF(1 month after medication, r=0.945, 0.922, 0.925;3 months after medication, r= 0.621, 0.706, 0.799, all P<0.001), while GWW was negatively correlated with LVEF(1 month after medication, r=-0.960. Three months after medication,r=-0.789, all P<0.001). And the differences of each index before and after medication were statistically significant(P<0.001).Conclusions: Myocardial function in patients with chronic heart failure was improved after taking sacubitril/valsartan. Left ventricular myocardial functional parameters can be used to evaluate the condition and prognosis of patients with chronic heart failure.

关 键 词：心力衰竭 心室功能 左 超声心动描记术 

分 类 号：R541.6[医药卫生—心血管疾病] R540.45[医药卫生—内科学]